Depew, Travis Wade
Depew, Travis Wade is an individual health care provider with primary practice located at 29520 Canvasback Dr , Easton MD 21601-7124. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Depew, Travis Wade can be contacted via phone (410) 822-5007.Contact Information
Primary practice address
29520 Canvasback Dr
Easton MD 21601-7124
Phone: (410) 822-5007
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1396105862 |
|---|---|
| LBN Legal business name | Depew, Travis Wade |
| Credentials | Bachelor of Arts (BA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2016 |
| Last updated | Feb 26th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396105862 | NPPES |
| Maryland | MEDICAID | 609500301 |
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